Infant CPR Changes in the United States
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Infant CPR Changes in the United States
What First Aid Trainers in Australia Need to Know
You may have recently seen some discussion on social media about changes to infant CPR in the United States. The American Heart Association (AHA) has updated its guidance, and some of the demonstrations circulating online look slightly different from what we teach here in Australia.
For first aid trainers, this naturally raises an important question:
Does this change what we should be teaching in Australia?
The short answer is no.
What Has Changed in the United States?
The latest guidance from the American Heart Association indicates that the two-finger compression technique is no longer the preferred method for infant CPR.
Instead, their guidance now favours:
- Two-thumb encircling technique
- Heel-of-the-hand technique (in some contexts)
In the United States, an infant is defined as a child under 1 year of age, which aligns with how we define infancy in Australia.
These changes are based on evolving research looking at compression depth, quality and rescuer fatigue during infant CPR.
You can view the updated AHA publication HERE
Does This Change Australian Practice?
No.
In Australia, we follow the guidelines developed by the Australian and New Zealand Committee on Resuscitation (ANZCOR).
At the time of writing (March 2026), ANZCOR guidelines for infant CPR have not changed.
This means:
- Trainers in Australia should continue teaching the current ANZCOR recommendations.
- Course materials and assessments should remain aligned with ANZCOR guidance.
For Australian trainers, the priority remains high-quality compressions. Compressions should achieve one-third of the depth of the infant’s chest with full recoil between compressions. If a rescuer cannot achieve this using two fingers, they should switch to an alternative technique such as the heel of one hand.
The “under 1 year” age definition is only a guide. In practice, rescuers should use the technique that works best based on the size of the child, ensuring compressions are deep and effective.
It is not unusual for international guidelines to differ slightly. Organisations such as the American Heart Association, ANZCOR and others review evidence independently and may adopt changes at different times.
Why Do Guidelines Sometimes Differ?
Resuscitation science is constantly evolving. Guideline bodies review new evidence, but they may:
- Interpret the evidence slightly differently
- Prioritise different outcome measures
- Update recommendations at different times
This means it is completely normal for international guidelines to vary.
For trainers, the key principle remains simple:
Teach the guidelines that apply in your country.
Expect Questions from Learners
In today’s world, learners often arrive at courses having already watched demonstrations online.
With the reach of platforms like Instagram, TikTok and YouTube, it is increasingly likely that participants will come across American CPR demonstrations.
If a learner asks why a video looks different to what you are teaching, a simple explanation works best:
“That video is likely demonstrating the American Heart Association guidelines. In Australia we follow ANZCOR guidelines, so the technique we teach reflects the recommendations used here.”
This helps reinforce two important ideas for learners:
- Guidelines can vary internationally.
- First aid practice should follow the local evidence-based guidelines.
What If the Australian Guidelines Change?
If ANZCOR updates its recommendations in the future, NIFAT will ensure trainers are informed.
One of the core goals of the National Institute of First Aid Trainers community is to help trainers stay up to date with evidence-based practice and guideline changes.
When updates occur, we will:
- Analyse the change
- Explain what it means for trainers
- Provide practical guidance on how to implement it in training
The Bottom Line for Trainers
For now:
- Australian infant CPR guidelines have not changed.
- Continue teaching ANZCOR guidance.
- Be prepared to explain differences learners may see online.
And as always, if anything changes, NIFAT will keep you informed.
Sign up to the NIFAT Newsletter HERE to ensure you don’t miss an update[/vc_column_text][/vc_column][/vc_row]
Hello I have just read this
I was aware of the changes
Due to significant variations in infants sizes
I could see some of the rationale with the USA recommendations
Two fingers may not achieve the required depth of one third for initial attempts
Or a prolonged time period even after 5 minutes
If three fingers do a better job then use it
If you could do the circumferential say for a new born as history has shown
Then perhaps that will work better as a cardiac and thoracic pump
The use of a hand could be in the wrong context a bit concerning
Especially if it extends beyond the zyphoid process
However if the infant is large and you cannot with two fingers obtain the 1/3 rd
There is one main reason we adhere to the ARC guidelines
The fear of legal litigation as that is what you will be judged on in a court of law
The main word here is guidelines
If you could in a court of law explain and have support documentation from other agencies or countries
That explain why you used that method
The ARC yes they are a very regarded organisation and do awesome work and have excellent guidelines
However the USA and Europe are also very highly regarded
If you look at clinical efficacy and patient outcome
You have the background to understand why you are varying the technique to improve patient outcome
That should be the major concern